影响复杂的三级急救中心质量指标的障碍和挑战。

Global journal on quality and safety in healthcare Pub Date : 2024-07-31 eCollection Date: 2024-11-01 DOI:10.36401/JQSH-24-10
Mohammad J Jaber, Alanoud A Bindahmsh, Mohammad A Abu Dawwas, Susanna E du Preez, Abeer M Alshodukhi, Ismail S Alateeq, Norah S Binti Abd Rahman
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引用次数: 0

摘要

引言医院绩效主要受外部因素(政治和经济)而非内部因素(效益和效率)的影响。急诊科(ED)人满为患是全球急诊服务面临的一个重大问题,其特点是就诊人数不断增加,问题长期得不到解决,导致急诊科工作人员面临更多挑战,患者满意度下降。本研究旨在探讨导致急诊室质量指标(QIs)差异的障碍和挑战,这些指标基于五个领域:基础设施、人口、工作流程、劳动力和管理:方法:沙特阿拉伯的一家三级急诊中心采用横断面描述性设计,对 180 名护士进行了标准化问卷调查:大多数护士(75.5%)认为,急诊室拥挤的候诊室是影响质量指标的最大因素。此外,还发现了许多其他挑战,包括床位容量、分诊区/工作流程、高峰期人流量增加、非急诊就诊需求、人员和短缺等。护士的回答在教育水平(仅针对基础设施,p = 0.004)、专业(仅针对护理管理,p = 0.052)和急诊室经验(针对所有变量,p = 0.008-0.039)方面存在显著差异:分析揭示了基础设施、工作流程、人口、劳动力和护理管理等对急诊室病人流量有重大影响的关键因素。了解这些方面将极大地影响急诊室绩效的质量衡量标准,并有助于决策者制定战略计划,提高急诊室的绩效。因此,成功实施和优化急诊室资源在很大程度上取决于考虑正确的决策变量和资源限制。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Obstacles and Challenges Affecting Quality Indicators in a Complex Tertiary Emergency Center.

Introduction: Hospital performance is significantly affected by external factors (political and economic) rather than internal factors (effectiveness and efficiency). Emergency department (ED) overcrowding is a significant issue for emergency care services globally, characterized by a rising number of visits and persistent unsolved issues, resulting in increased challenges faced by ED staff and decreased patient satisfaction. This study aimed to explore the obstacles and challenges that cause variation in ED quality indicators (QIs) based on five domains: infrastructure, population, workflow, workforce, and administration.

Methods: A tertiary emergency center in Saudi Arabia administered a questionnaire with standardized measures to 180 nurses, using a cross-sectional descriptive design.

Results: Most nurses (75.5%) believed that crowded waiting rooms in the ED were the most influential factor affecting QIs. Many other challenges were identified, including bed capacity, triage area/workflow, increased volume during peak periods, demand for nonemergency visits, staff and shortages. Significant differences in nurses' responses were found on the basis of education level (for infrastructure only, p = 0.004), specialty (for nursing administration only, p = 0.052), and ED experience (for all variables, p = 0.008-0.039).

Conclusion: The analysis uncovered various critical aspects of infrastructure, workflow, population, workforce, and nursing administration that have a major effect on patient flow in the ED. Comprehending these aspects will greatly affect the quality measures of ED performance and assist policymakers in formulating strategic plans to enhance ED performance. Therefore, successful implementation and optimization of ED resources depend greatly on considering the right decision variables and resource restrictions.

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